Abstract

Background

Anaemia is a frequent complication in cancer patients. This haematological abnormality may be related to cancer itself and/or induced by chemotherapy. The objective of the present study was to describe the prevalence of anaemia in treatment-naïve patients with solid tumours, the incidence of anaemia after four months of cancer treatment and anaemia management.

Methods

Multicenter, prospective and observational study that included newly diagnosed cancer patients. Data on anaemia parameters and its management were collected at baseline and after four months of cancer treatment. The primary outcome was the proportion of patients with anaemia defined as a haemoglobin (Hb) concentration <12 g/dL. Moreover, we studied the prevalence and incidence of iron-deficiency (ID) defined by a transferrin saturation < 16%.

Results

The study included 295 patients (153 females), with a mean (±SD) age of 61.6 (±12.5) years and an ECOG performance status of 0-1 in 90.3% of the patients. The prevalence of anaemia at cancer diagnosis was 38.6% (49.4% for gastrointestinal [GI], 35.7% for lung and 27.3% for breast cancer patients). The severity of anaemia at baseline was moderate in 20.2% of patients. Prevalence of ID was 48.5% among those patients with available data and 51.9% in anaemic patients. A total of 106 patients (60.2%) without anaemia at baseline, developed anaemia over the four months of cancer treatment (39.5% for GI, 59.3% for lung and 75.5% for breast cancer patients). Baseline anaemia was treated only in 32.5% patients. At the four-month visit, 47.4% of anaemic patients at baseline and 67% of patients with new-onset anaemia had not received anaemia treatment.

Conclusions

The prevalence of anaemia and iron deficiency in treatment-naïve cancer patients is very high. While the prevalence of anaemia was higher among GI cancer patients at baseline, the incidence of anaemia during chemotherapy treatment was higher in breast cancer patients. Despite international recommendations, our study indicates an undertreatment of anaemia in cancer patients.